Emergency Contraceptive Pills: Side Effects and Menstrual Cycle Impact

Emergency contraceptive pill

Hello doctor, my girlfriend's menstrual period was from September 24 to October 1.
On October 2, we had unprotected intercourse with ejaculation outside, and she took emergency contraception within an hour.
On October 7, she experienced bleeding symptoms.
Is this a side effect of the medication or is her period starting? If it is her period, should we recalculate her cycle? If there is bleeding, is there still a chance of pregnancy?

1122333, 10~19 year old female. Ask Date: 2016/10/09

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, emergency contraceptive pills can sometimes cause irregular menstruation.
It's advisable to monitor if it improves in the following month.
It's best to use preventive measures beforehand, and you should not be pregnant.
Wishing you good health.

Reply Date: 2016/10/09

More Info

Emergency contraceptive pills (ECPs), commonly known as the "morning-after pill," are designed to prevent pregnancy after unprotected intercourse or contraceptive failure. They are most effective when taken as soon as possible after the incident, ideally within 72 hours, but some formulations can be effective up to 120 hours post-intercourse. The two most common types of ECPs are those containing levonorgestrel (Plan B One-Step) and ulipristal acetate (ella).

When your girlfriend took the emergency contraceptive pill shortly after the unprotected intercourse on October 2, it was a timely decision aimed at preventing pregnancy. The bleeding she experienced on October 7 could be a side effect of the ECP or an indication that her menstrual cycle is being affected.

Side Effects of Emergency Contraceptive Pills
1. Bleeding: Spotting or bleeding can occur after taking ECPs. This is often due to hormonal changes induced by the medication. It does not necessarily indicate the start of a new menstrual cycle.

2. Nausea and Vomiting: Some women may experience nausea, and in some cases, vomiting. If vomiting occurs within two hours of taking the pill, it may be necessary to take another dose.

3. Fatigue and Headaches: Hormonal fluctuations can lead to feelings of fatigue and headaches.

4. Breast Tenderness: Hormonal changes can also cause breast tenderness.

5. Changes in Menstrual Cycle: ECPs can cause changes in the timing of the next menstrual period. It may come earlier or later than expected, and the flow may be lighter or heavier than usual.

Impact on Menstrual Cycle
If the bleeding on October 7 was indeed a side effect of the ECP, it may not signify the start of a new menstrual cycle. Instead, it could be breakthrough bleeding due to the hormonal changes from the pill. The next menstrual period should be tracked based on the typical cycle length. If her cycle is regular and she experiences bleeding that resembles her usual period, it can be considered the start of a new cycle.

Risk of Pregnancy
If your girlfriend took the ECP within the recommended time frame after unprotected intercourse, the likelihood of pregnancy is significantly reduced. However, no contraceptive method is 100% effective. If she experiences a delay in her next period (more than a week late), it would be advisable for her to take a pregnancy test to confirm whether or not she is pregnant.

Conclusion
In summary, the bleeding your girlfriend experienced could be a side effect of the emergency contraceptive pill rather than the onset of her menstrual cycle. It is essential to monitor her next period and any further symptoms. If there are any concerns about pregnancy or if her menstrual cycle does not return to normal, consulting a healthcare provider would be the best course of action. They can provide further guidance and support based on her individual health needs.

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